Investigation And Analysis Of The Use Of Antibiotics In A Particular Hospital

Objective:To fully investigate the use of antibiotics in a particular hospital. To grasp the utilization and consumption status of antibiotics in this particular hospital. To evaluate the rationality of using antibiotics in surgical and non-surgical inpatients and outpatients as to providing reference for this hospital to provide better pharmaceutical service, rationalize the clinical use of antibiotics, improve the outcomes of clinical treatments and reduce the economic burden of the patients and the society.Methods:The data of antibiotics consumption are collected by the computer, including the gross sales of the total drugs, the gross sales of the antibiotic drugs, the proportion of the antibiotics to the total drugs; The samples used to evaluate the rationality of using antibiotics are randomly selected from 100 inpatient cases and 100 outpatients cases per month in 2008, making a total number of 1200 in each category. The data are arranged and statistically analyzed separately by designing corresponding questionnaire to each category. The content of the questionnaire include: the choices and utilization of antibiotics for inpatients, the standardization level of utilizing antibiotics in the surgical period, the management index of each prescription in outpatient cases. The similarities and differences of antibiotics usage among outpatients, surgical and non-surgical inpatients are analyzed. The status of examine infectious and disease-causing pathogens and bacterial culture rate is assessed. The rationality of drug treatment is evaluated by setting a maximal daily usage.Results:The average ratio of gross sales of antibiotic drug to total drugs is 18.28%; the utilization of antibiotics is diverse, and the commons ones involves 83 types falling into 8 categories.51.75% of the prescriptions in this hospital contains antibiotics.40.08%,46.46% and 100% prescriptions in outpatient, non-surgical and surgical cases contains antibiotics, respectively.44.36% prescription use combination of antibiotics. In 11.19% cases, the pathogens were examined, whereas as high as 88.81% prescriptions are given based on doctors'experience. The timing of using prophylactic medicine in surgical period is not reasonable. In 380 surgical patients, only 58 (15.26%) patients were given the first usage of antibiotics in the anesthesia induction or 60 minutes prior to the skin dissection. The period for after-surgical antibiotics treatment is too long. In only 10 cases (7.58%), the treatment is shorter than 24 hr while in only 5 cased (2.58%) the treatment is shorter than 48 hr. In addition, there are 14 inpatients who were infected.8 inpatients who were given antibiotics after they showed negative in skin tests, developed into delayed allergy. Only in 2 patients did the pathogens examination and bacterial culture. Conclusion:40.08% and 46.46% prescriptions in outpatient, non-surgical contains antibiotics, respectively. This is below the standard in the hospital management regulation set by state department of health that the utilization of antibiotics should be controlled in under 50% of the cases. The use of antibiotics in outpatient, non-surgical patients, is mostly rational. Irrational use of antibiotic drugs exists in view of the antibiotics usage in the entire hospital. The irrational use of antibiotics are represented by:higher ratio of cases involving antibiotic treatment, relatively lower ratio of cases involving in pathogen examine and drug allergy test, relatively higher ratio of cases involving in combination of antibiotic treatment, misuse of antibiotics in surgical period. There is a large different between outpatients and inpatients group. For instances, the ratio of cases using antibiotic and combined antibiotic treatment, the quality of antibiotics and the ratio of antibiotic expenses in gross expenses of prescription drugs is higher in inpatients than those in out patients. The irrationality of using antibiotics is more prominent in surgical inpatients comparing to non-surgical inpatients and outpatients. As a result, to solve the problems reflected by the questionnaire, we should execute and follow the 'the guideline for using antibiotics in clinical cases', intensify the knowledgable training of rationally use of antibiotics to the clinical personnel, attach importance to the pathogen examine and allergy test, adjust and intervene the use of antibiotics in time in accordance to the development of bacterial drug resistance, improve the efficacy of using antibiotics, avoid the development of antibiotic resistant bacterial strain in the hospital, promote the rational use of antibiotics, continuously improve the level of rational use of antibiotics in this hospital.